12例肝脏肉芽肿的MRI表现  

MRI Findings of Hepatic Granuloma in 12 Cases

作　　者：肖渤瀚[1] 刘佩芳[1] 尹璐[1] 

机构地区：[1]天津市肿瘤防治重点实验室天津医科大学附属肿瘤医院放射科,天津市300060

出　　处：《中国肿瘤临床》2008年第10期551-554,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨肝脏肉芽肿的MRI表现,提高对本病诊断的准确性。方法:对天津医科大学附属肿瘤医院2004年4月～2007年10月经手术病理证实的12例肝脏肉芽肿进行回顾性分析,其中肝脏结核7例,肝脏肺吸虫病2例,特发性肉芽肿3例。全部病例均行上腹MRI检查,序列包括T1WI、T2WI、动态增强MRI(DCE-MRI)和弥散加权(DWI)。结果:12例肝脏肉芽肿共13个病灶,其中4个为肉芽肿中早期病灶,9个为纤维化期病灶。1)肉芽肿中早期病灶T1WI呈低信号,T2WI呈较高信号,边界模糊,DCE-MRI于动脉期呈不均匀环形强化,门静脉期及延迟期强化程度逐渐增加,DWI呈稍高信号,ADC值为(1.347±0.379)×10-3(mm2/s),ADC比率为1.103±0.165。2)纤维化期病灶T1WI呈低信号,T2WI呈等信号,边界清楚,DCE-MRI无明显强化或仅边缘线样强化,DWI呈稍高信号,ADC值为(1.382±0.398)×10-3(mm2/s),ADC比率为0.978±0.116。结论:肝脏肉芽肿的MRI信号表现能反映其所处的病理时期,并可以与肝脏其它肿物鉴别,因而MRI在肝脏肉芽肿诊断中具有较高价值。Objective： To investigate the MRI features of hepatic granuIoma. Methods： Data from 12 cases of granuloma （7 cases of tuberculosis, 2 cases of paragonimiasis, and 3 eases of idiopathic granuluma） proved by surgery and pathology were retrospectively analyzed. All of the patients underwent TIWI, T2WI, dynamic contrast-enhanced MRI （DCE-MRI）, and diffusion weighted imaging （DWI）. Results： A total of 13 lesions were found in these cases, including 4 lesions at the early and middle stages of granuloma and 9 lesions at the fibrosis stage. The lesions at the early and middle stages were hypointense on T1WI, hyperintense on T2WI, with an ill-defined margin. These lesions showed inhomogeneous circular enhancement in the arterial phase of DCE-MRI and then gradually went to increase in the portal and delayed phase. These lesions were slightly hyperintense on DWI, with an average ADC value of （1.347±0.379）×10^-3 mm^2/s and an ADC ratio of 1.103±0.165. The lesions at the fibrosis stage were hypointense on T1WI, isointense on T2WI, with a well-defined margin. These lesions showed only slight enhancement or no enhancement in DCE-MRI. These lesions showed hyperintense on DWI , with an average ADC value of （1.382±0.398）×10^-3 mm^2/s and an ADC ratio of 0.978±0.116. Conclusion： The MRI findings may reflect different stages of hepatic granuloma and are helpful to differentiate it from other liver focal lesions.

关 键 词：肉芽肿 肝脏 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]